ABSTRACT
Background: Drug-food interactions can lead to adverse drug reactions and therapy failure which can potentially impact patient safety and therapy outcome. Objectives: This study assessed patients' knowledge, attitudes and practices regarding drug-food interactions. Methods: A cross-sectional study was conducted among patients at three public hospitals in eThekwini, KwaZulu-Natal. Statistical analysis was performed using SPSS® version 25. The association between demographic variables and patients' knowledge, attitudes and practices were assessed. Results: Of the 342 patients, 70.5% were female, and the mean age was 42.87±0.89 years. Almost 50% of patients had secondary level education, and 64% were unemployed. About 52% of patients had high knowledge of drug-food interactions; however, only 30-50% of the patients could identify potential drug-food interactions of their drugs. More than half of the patients (51.5%) answered that they took multivitamin pills with medications and 61.7% responded they consulted healthcare professionals for drug-food interactions' information before taking new medications. Few patients (15.2%) had experienced drug-food interactions. Conclusions: Overall, patients had gaps in their knowledge and practices, and positive attitudes towards drug-food interactions. Many patients could not identify food items that can potentially interact with their drugs. It is important that education and medication counselling are provided to patients to prevent drug-food interactions, ensure optimal drug therapy and patient safety
Subject(s)
Attitude , Food-Drug Interactions , Artificial Life , Patients , Practice Guidelines as TopicABSTRACT
Objective: To identify frequency, type, severity and predictors of potential drug-drug interactions(pDDIs), potential drug-food interactions(pDFIs), potential drug-alcohol interactions(pDAIs) and potential drug-tobacco interactions(pDTIs) and most frequently interacting drug combination pairs in hospitalized patients from departments(depts) of General Medicine(GM), Orthopedic(Ortho), Gynecology(OBG), Pulmonology(Pulmo), General Surgery (GS), Psychiatry (Psych), Otolaryngology(ENT) and Dermatology (Derm) of study population. Methods: A Prospective Observational Study was conducted in eight major dept's of a tertiary care teaching hospital for a period of 6 mo. A sample size of 650 prescriptions reflecting admission no's for each department were used. Results: A total of 650 patients were included in the study. Among them, 282(43.4%) were males and 368(56.6%) were females. The mean age of the study population was 39.67±15.23. A total of 487 pDDIs, 734 pDFIs, 586 pDAIs and 159 pDTIs were found out of 650 hospitalized episodes. OBG showed the highest pDDIs and pDAIs. Highest pDFIs and pDTIs were seen in Pulmo. The majority of DDIs were minor, DFIs and DAIs were moderate and DTIs were of major in severity. Pharmacokinetic types of interactions were seen in the majority of the depts. Logistic regression analysis showed that Polypharmacy was associated with the occurrence of DIs. Most of the DIs repeated several times in particular depts and a list of these combinations was prepared. Conclusion: With the high occurrence of overall DIs and characteristic patterns of DIs combination pairs among different departments of the hospital, the presence of clinical pharmacists in hospitals can play a great role, especially in developing nations like India where their role in hospitalized settings is always controversial.
ABSTRACT
Physiological changes associated with aging affect the absorption, distribution, metabolism, and excretion of drugs and thus therapeutic outcomes. These changes may be further amplified by interactions with nutrients. The purpose of this review was to summarize drug-nutrient interactions found in elderly patients. Mechanisms of the interactions can be categorized as ex vivo bio-inactivations, interactions in absorption and elimination phases, and physiological interactions. The goal of enteral nutrition (EN) is to maximize the therapeutic response of medication without adversely affecting EN tolerance. Therefore, to ensure safety, consistent monitoring is necessary for enteral feeding of patients receiving medication via an enteral tube. Elderly patients receiving parenteral nutrition (PN) are often treated concomitantly with medication via the parenteral route. The stability and compatibility of PN formulations infused with other additives, including medication, may be influenced. Limitation of the number of prescriptions to essential medications only during the minimum period along with periodic re-evaluations of the treatment are thus necessary to minimize undesirable drug-nutrient interactions in elderly patients.
Subject(s)
Aged , Humans , Absorption , Aging , Enteral Nutrition , Food-Drug Interactions , Metabolism , Nutritional Support , Parenteral Nutrition , PrescriptionsABSTRACT
Levodopa is the principal pharmacological treatment for Parkinson's disease (PD); however the protein content in diet may compromise its effectiveness. The aim of this study was to investigate the relationship of protein intake and the use of levodopa in ambulatory patients with PD. Thirty four PD patients were assessed for protein intake, evaluating the relation energy-protein intake by means of a register. An intake of 1762 kcal/day, 70.9 g of protein/day equivalent to 16.6% of the total energy intake as protein at a level of 1.1 g/kg bw/day. Of all patients, 47.1% took their medications with meals. We conclude that the studied patients consume more protein in their diet than those recommended for PD, with half the sample taking the medications with meals, which may affect the treatment.
La levodopa es el principal tratamiento farmacológico para la enfermedad de Parkinson, sin embargo, la proteína de la dieta puede comprometer su eficacia. El objetivo de este estudio fue investigar la ingesta de proteínas y el uso de la levodopa en pacientes con enfermedad de Parkinson tratados en régimen ambulatorio, 34 pacientes fueron evaluados. Evaluación de la ingesta de alimentos por los registros, tomas de 1762 kcal/día, 70.9 g/día, el 16,6% del total de energía y 1.1 g/kg/dia de energía y proteína, respectivamente, y que la ingesta de proteínas durante el día era 70,4% del total de proteínas diario. Todos los pacientes estaban tomando levodopa y 47,1% consumían sus medicamentos con las comidas. Se concluyó que, según las recomendaciones para la enfermedad de Parkinson, los pacientes estudiados consumían una dieta rica en proteínas y con una mayor concentración de este nutriente durante el día. Aproximadamente la mitad de la muestra ingiere los medicamentos con la comida, costumbre que puede afectar el tratamiento farmacológico de la enfermedad.
Subject(s)
Humans , Parkinson Disease , Patients , Proteins , Levodopa , Diet , Neurodegenerative DiseasesABSTRACT
Este artigo trata da interação entre fármacos e nutrição enteral quando ambos são administrados por sondas. O objetivo foi identificar publicações sobre o tema. A metodologia foi uma revisão em quatro bases eletrônicas compreendendo o período de 1997 a 2007. Foram encontrados 62 artigos e selecionados sete, mostrando que as classes farmacológicas dos antiepiléticos, antibióticos e anticoagulantes apresentaram maiores índices de interação. A classe com maior risco de interagir com a nutrição enteral foi a dos antiepiléticos. Entre os antibióticos, somente o ciprofloxacino teve decréscimos significativos nos níveis séricos e a warfarina, único anticoagulante mencionado, apresentou interação com a nutrição enteral. Na conclusão, destaca-se a importância de iniciativas, como o hábito de lavar a sonda e interromper a dieta para prevenir e monitorar possíveis interações entre fármacos e nutrição enteral.
This article is about the interaction between pharmaceuticals and enteral nutrition when both are dispensed by probe used for nutrition support. It aimed at identifying the available publications on the subject. Methodology resorted to bibliographic review in four databases comprehending the span between 1997 and 2007. Sixty-two articles were found and seven were selected as showing that the pharmacological classes of the antiepileptic drugs, antibiotics, and anticoagulants presented higher interaction index. Antiepileptic drugs were found to be those with highest risk of interaction with enteral nutrition. Among the antibiotics, only the ciprofloxacin had significant decreases on serum levels and Warfarin, the only anticoagulant mentioned, also presented interaction risk. Conclusions show the relevance of initiatives, such as the cleaning of the probe and the interruption of the diet to monitor lab tests and to prevent possible interaction between drugs and enteral nutrition.
Este artículo se refiere a la administración concomitante de fármacos por sondas junto con la nutrição enteral. El objetivo fue identificar publicaciones acerca de la interacción entre fármacos y nutrición enteral administrados por sonda. La metodología fue una revisión que uso datos de bases electrónicas en el período de 1997 a 2007, habiendo encontrado 62 artículos y seleccionados siete, en los cuales se muestra que las clases farmacológicas encontradas de antiepiléticos, antibióticos y anticoagulantes son las que tienen mayor índice de interacción. La clase que más demostró riesgo de interacción con la nutrición enteral fue la de los antiepilépticos, principalmente la fenitoína. Los antibióticos no demostraron significativos decréscimos en los niveles séricos y la warfarina, único anticoagulante mencionado, también presentó riesgo de interacción con la nutrición enteral. Como conclusión, se hace necesario iniciativas como el hábito de lavar la sonda, interromper la nutrição enteral y monitorizar exámenes laboratoriais para prevenir posibles interacciones entre fármacos y la nutrición.